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Reconciling Patient Safety and Epistemic Humility

An Ethical Use of Opioid Treatment Plans

Bibliographic Data

ID20337723
AuthorsAnita Ho (0000-0002-9797-1326, corresponding author)
Year2017
Volume47
Issue3
Pages34-35
Publication date2017-05-01
Open AccessYes
TypeARTICLE
VenueThe Hastings Center Report (JOURNAL)
Journal identifiersISSN: 0093-0334 • E-ISSN: 1552-146X
PublisherWiley (PUBLISHER • GB)
DOI10.1002/hast.703
PMID28543418
OpenAlexW2618500970
LanguageEN
Citations received4
References cited11

In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz suggest using opioid treatment agreements as public health monitoring tools to inform patients about “the requirements entailed by undergoing opioid therapy,” rather than as contractual agreements to alter patients’ individual behavior or to benefit them directly. Because Rager and Schwartz's argument presents suspected OTA violations as a justification to stop providing opioids yet does not highlight the broader epistemic and systemic context within which clinicians prescribe these medications, their proposal may perpetuate a climate of distrust and stigmatization without correcting systemic factors that may have placed patients and others at risk in the first place. Given the context of epistemic uncertainty regarding opioid safety and efficacy, insufficient training for opioid prescribers, and inadequate patient education, I propose replacing OTAs, which have a narrow focus on patient behaviors, with opioid treatment plans, which would promote mutual, collaborative, and shared decision‐making on the most appropriate pain management program. An OTP can be ethically justified as a tool to prevent and treat iatrogenic addiction under a specific paradigm—one that adopts a default position of professional epistemic humility and holds all collaborative parties accountable in chronic pain management

Addiction · Argument (complex analysis) · Context (archaeology) · Distrust · Humility · Opioid · Political science · Psychiatry · Psychotherapist · Law · Medicine · Opioid Use Disorder Treatment · Palliative Care and End-of-Life Issues · Prenatal Substance Exposure Effects · Psychology

  • Enacting Epistemic Justice to Promote Safer Care for People Living with Chronic Pain

    Open Access•Catherine Côté, Catherine Isadora Côté•Journal of Bioethical Inquiry•2026

  • A critical and systematic literature review of epistemic justice applied to healthcare

    Open Access•Catherine Côté•Medicine Health Care and Philosophy•2024

  • ‘First Do No Harm’

    Adrienne Sabine Beck, Larisa Svirsky et al.•Journal of Medical Ethics•2022

  • Restrictive opioid prescribing policies and evolving risk environments

    Open Access•Shane R Mueller, Jason M Glanz et al.•International Journal of Drug…•2021

  • Investigating Trust, Expertise, and Epistemic Injustice in Chronic Pain

    Open Access•Daniel Z Buchman, Anita Ho et al.•Journal of Bioethical Inquiry•2017

  • Defending Opioid Treatment Agreements

    Open Access•Joshua B Rager, Peter H Schwartz•The Hastings Center Report•2017

  • Trusting experts and epistemic humility in disability

    Anita Ho•International Journal of Feminist…•2011

Citations per year0.8
Citation span2021 - 2026 (6)
Highly citedNo

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